مقایسه اثربخشی درمان مبتنی بر تعهد و پذیرش، بر ولخرجی و سوء مصرف شیشه در بیماران با تشخیص اختلال دوقطبی و اختلال شخصیت مرزی (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
پژوهش با هدف اثربخشی درمان مبتنی بر تعهد و پذیرش بر ولخرجی و سوء مصرف شیشه در بیماران با تشخیص اختلال دوقطبی و اختلال شخصیت مرزی انجام شد. طرح پژوهش، پیش آزمون، پس آزمون و گروه کنترل بود. جامعه پژوهش بیماران مبتلا به اختلال دوقطبی و اختلال شخصیت مرزی بودند که به اردوگاه کرامت درشهرستان مبارکه اصفهان در سال 1400 مراجعه نموده اند. ملاک های ورود به نمونه عبارت بودند از اینکه: حداقل چهار ماه از بستری شدن گذشته باشد، بیمار تشخیص اختلالات دوقطبی یا شخصیت مرزی را گرفته باشد، حداقل به مدت دو هفته دارو مصرف نکرده باشد، و در مداخلات درمانی دیگر شرکت نکرده باشد. نمونه پژوهش چهار گروه 15 نفری(15 نفر بیماران دوقطبی گروه آزمایش، 15 نفر بیماران دوقطبی گروه کنترل، 15 نفر بیماران اختلال شخصیت مرزی گروه آزمایش، 15 نفر بیماران اختلال شخصیت مرزی گروه کنترل) بودند که به روش نمونه گیری در دسترس انتخاب شدند. این چهار گروه در دو مرحله پیش آزمون و پس آزمون ارزیابی شدند. ابزار اندازه گیری: پرسشنامه چند محوری بالینی میلون3(1994) و آزمون مقیاس کنترل شخصی یا PCS و پرسشنامه ولخرجی کلارکی و مورتیمر(2013) بود. سپس اطلاعاتبدست آمده به روش آماری تحلیل کوواریانس به وسیله نرم افزار SPSS مورد تجزیه و تحلیل قرار گرفت. نتایج نشان داد که درمان مبتنی بر تعهد و پذیرش در گروه آزمایش با تشخیص اختلال دوقطبی در مصرف شیشه اثر بخش بود (0/05 p < ) ولی بر ولخرجی اثربخش نبود. (0 /05< p ) و درمان مبتنی بر تعهد و پذیرش در گروه آزمایش با تشخیص اختلال شخصیت مرزی برمصرف شیشه و کنترل ولخرجی اثربخش بود (05/0 < p ) ، این در حالی بود که در هیچ کدام از دو گروه کنترل تغییری حاصل نشد.The Impact of Acceptance and Commitment Therapy (ACT) on the Extravagance and Methamphetamine Abuse in Patients with Bipolar Disorder and Borderline Personality Disorder
Introduction A mental damage that can be observed in the users of methamphetamine is bipolar disorder, which happens because of high consumption of the drug. Another psychological problem observed among methamphetamine abusers is borderline personality disorder. People with bipolar disorder and borderline personality disorder need appropriate interventions, and acceptance and commitment treatment (ACT) can be a good choice. This study aimed to explore the impact of commitment and acceptance treatment on extravagant and methamphetamine abuse in people with bipolar disorder and borderline personality disorder. Method This quasi-experimental research used a pre-test and post-test and a control group design, including four groups (two experimental groups and two control groups). The inclusion criteria were: at least four months had passed since the participants had been hospitalized for withdrawal methamphetamine, they had been diagnosed as people with bipolar disorder or borderline personality disorder, they did not take psychiatric drugs during the treatment, and they did not participate in other therapeutic interventions at the same time. The exclusion criteria were: the participant did not want to continue the therapy, the participant with bipolar disorder and borderline personality disorder have other disorders, and the participant age is over 55. The aims of the study were explained to the participants and their written consent was obtained. They were explained that all information of the participants will remain confidential and will be used only for research purposes. The statistical population of this research included all people with bipolar and borderline personality disorder admitted to Karamat Camp in Mobarakeh city of Isfahan in 2021. The population includes those who both used methamphetamine and suffered extravagance. From among the people with bipolar disorder and borderline personality disorder, 60 people (30 people for each group) were selected using available sampling and they were randomly divided into experimental and control groups. They were selected after performing Millon Clinical Multiaxial Inventory questionnaire and diagnosed by a psychiatrist and a psychologist of the camp. The participants were evaluated both in pre-test and post-test phases. The experimental groups participated in therapeutic commitment and acceptance interventions for 9 sessions, one and a half hours, three sessions per week. The control groups did not participate in any type of intervention. During the sessions, there was no drop in the number of participants. SPSS 23 was used for analysis of covariance. The measuring instruments were: a) Millon Inventory 3, designed by Millon (1994). The most recent version of this questionnaire consists of 175 items, scored under 28 separate scales; b) Personal Control Scale, known as PCS (Shua Kazemi, 2010). This test consists of 15 items and evaluates the degree of personal control over drug abuse (in past and now). This test includes two sets of questions. The person’s conditions over the past 90 days is examined in the first part and his conditions when starting drug abuse is examined in the second part; C) Clarke and Mortimer’s Extravagance Questionnaire (Clarke & Mortimer, 2013). This questionnaire consists of 19 items. The sum of scores will be between 19 and 95. The range 9-44 shows appropriate management of life expenditures, 45-68 shows medium expenditures, and 69-95 indicates extravagance and being thoughtfulness after the expenditure. Results The results showed that ACT was effective for metaphemtamine abuse treatment in the experimental group with bipolar disorder ( p <0.05), but it was not effective for extravagance treatment (P>0.05). Moreover, ACT impacts the metamphetmaine abuse and extravagance control in the experimental group with borderline personality disorder (P<0.05), while there was no change in the control groups. Discussion and Conclusion The results confirm the effectiveness of Acceptance and Commitment Treatment (ACT) for the treatment of methamphetamine abuse in people with bipolar and the treatment of methamphetamine abuse and extravagance in people with borderline personality disorder. It is suggested that ACT-based therapeutic interventions be used in addiction treatment centers. Moreover, it is suggested that researchers try to find the best model for methamphetamine abuse treatment by comparing ACT method with other treatment methods. This study focused on people with bipolar and borderline personality disorder and it is suggested that future studies explore the relationship between methamphetamine abuse and ten types of personality disorder.
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